Mental Health Services

Approximately 5 percent of adults age sixty-five and over live in nursing homes (U.S. Bureau of the Census). The rate of mental disorder in this institutionalized population is high, and access to services is disturbingly low. Deinstitutionalization of state mental hospital patients in the 1960s and 1970s resulted in the reinstitutionalization, into nursing homes, of many elderly patients. Nursing homes became de facto mental health settings but lacked the capacity to provide appropriate care. Related nursing home reforms were instituted in the late 1980s and early 1990s. Although improvements in care were achieved, studies measuring the effects of these reforms have confirmed, without exception, a continuing problem with low mental health treatment and service utilization rates among nursing home residents (Smyer and Qualls).